Sunday, September 11, 2011

NJH, Denver

June 22, 2011
I’m in the first floor waiting room at National Jewish Health in Denver, scheduled for an early morning bronchoscopy. This will probably be the most traumatic procedure of a week-long series of tests and consults intended to ferret out the underlying causes of my ever-worsening pulmonary function.
The paragraph above was written a little over two weeks ago, and it was correct.  I was so ill after the bronchoscopy that I couldn’t keep food down all that day.  In addition to throwing up, I coughed up blood and mucus all day long, slept most of the afternoon, then slept another eight or ten hours that night.  I was given permission to spend the night in the RV in the parking lot, because I was not supposed to drive at all that day, and I had no one else with me.  The next morning, I was able to eat half a bowl of oatmeal and drink some tea without throwing up.  I went back to NJH for appointments that day.  Still, I have been coughing up blood and some clots daily since the bronchoscopy (for two weeks).
 It is now July 8, and I am parked in the RV at my sister’s wilderness home on Kelsey Lake in the back woods of Michigan.  Yesterday, there was less blood when I coughed, but today seemed worse than before, so I tried to call the doctor at NJH.  The nurses dealt with me, but apparently did consult with the doctor; doctors at NJH are heavily protected by nurses and schedulers and other buffer-type personnel.  It’s not a very satisfactory arrangement for patients, but I guess it’s necessary, given the number of patients who pass through that place.
The NJH ordeal involved a week-long series of tests, explorations, consultations and instructions, mostly involving the respiratory system.  Blake was with me the first day, when I did some heavy walking with an oxymeter to check blood oxygenation, and then I had a type of simple pulmonary function test (“pulmonary spirometry”).  After these tests, I saw the doctor (Dr. Beuther) for an hour, and afterwards talked with a nurse.   I had a test (“exhaled nitric oxide”) that was supposed to provide information on the degree of inflammation in my lungs, after which Blake and I went to lunch.  He waited patiently, playing games on his DS in the various waiting rooms, while I was being put through the paces.  In the afternoon was Radiology, where I had a chest X-ray and CT scans of chest and sinuses.  That was followed by barium swallow tests, involving liquid, gel, and solid; it seemed to me I swallowed a lot of chalk in that process (and more the next day).  Afterwards, there was a full-blown, complicated pulmonary function test, where I sat in a little glass cage. 
That night, Blake and I camped in the huge parking lot at Denver International Airport and in the morning I made breakfast (fried rice) in the RV.  We took the parking lot shuttle to the airport, got his ticket (I had to give them an extra $100.00 in cash for an unaccompanied minor), and we went to his flight gate.  I had an envelope of papers relating to the unaccompanied minor flight to carry for him, which I almost left in a coffee shop where we got coffee! I waited until his flight taxied away from the gate before leaving the waiting area.
In the afternoon, back at NJH, there was a patient education session on asthma and another fluoroscope, this time looking at the esophagus.  I wondered why the esophageal and pharyngeal fluoroscopy couldn’t have been combined; I really didn’t like the idea of swallowing so much barium.
On Wednesday morning, early, I had the bronchoscopy, which was all I could handle for that day, and on Thursday, there was a Psychology consult, quite interesting, with a Dr. Pearson, who was very pleasant.  If I were looking for therapy, and if I lived there, she would be a person I might choose.  Then there were an ECG and an ECHO cardiogram, during part of which, they injected small air bubbles into a vein, looking for possible cardiac septal defects.  In the afternoon was another class on asthma management, and then skin tests on my back, looking for allergens to which I’m reactive.  It was a “South Carolina panel;” I was surprised that they had different batches of allergens for different states.
On Friday, I was still coughing up blood, so they didn’t do a scheduled spirometry, thinking it might further irritate the tracheobronchial linings.  In retrospect, it doesn’t seem like it would have made any difference.  After that, I saw Dr. Beuther for another consult. He gave me some ideas of what might be causing my problems, but said he’d have to wait for test and biopsy results to come back.
I left NJH about 1:00 PM Mountain Time (3:00 EST) driving north then east toward Nebraska; I was scheduled to be at a week-end conference at the Iowa Summer Writing Festival in Iowa City at 8:30 AM, early the following morning.

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